Pathology- Stomach

Question 1

Overall, what happens in the gastric mucosa to cause acute gastritis?

Answer 1

Disruption of the protective mucin lining of the stomach

Question 2

True or false: in acute gastritis, the epithelial cells are damaged along with the mucin layer.

Answer 2

FALSE. The surface epithelium is in tact.

Question 3

What type of WBC is present on the surface epithelia in acute gastritis?

Answer 3

Neutrophils

Question 4

What is the main and serious complication of NSAID use?

Answer 4

acute gastric ulceration

Question 5

What is the mechanism of NSAIDs to cause acute gastric ulceration?

Answer 5

they stop COX, which stops prostaglandin synth, which usually enhances bicarbs, which synthesizes mucin. so no mucin is produced.

Question 6

What is the name again of head trauma that enchances vagal response to cause ulcers?

Answer 6

Cushings ulcer

Question 7

True or False: In acute gastric ulceration, there are erosions with brown/block coloration and sharp borders, but there is no scarring/thickening of the blood vessels.

Answer 7

True

Question 8

So what is lost in acute gastric ulceration and not in acute gastritis?

Answer 8

The epithelial layer. thats why theres bleeding and erosion and shit in ulcers.

Question 9

What is the most common cause of chronic gastritis?

Answer 9

H. Pylori gastritis

Question 10

What happens to the gastrin levels in H. Pylori gastritis?

Answer 10

They;re low.

Question 11

What is the role of the flagella in H. Pylori? The urease? Adhesins? Toxins?

Answer 11

Flagella- mvmt. Urease- neutralize the acid. Adhesins- attachement. Toxins- damage.

Question 12

Where in the stomach does H. Pylori usually cause gastritis?

Answer 12

The antrum

Question 13

In intense H. Pylori colonization, it can spread subepithelially and cause what types of WBC’s to show up subepithelially?

Answer 13

neutrophils and plasma cells, which are characterisitc of H. Pylori

Question 14

What is the specialized test u can do for H. Pylori gastritis Dx?

Answer 14

Urease breath test

Question 15

What types of ppl are at risk for H. pylori infections?

Answer 15

poverty, childhood, can get H. helamnii from dogs/cats.

Question 16

This type of gastritis loses parietal cells from CD4 targeting of the H/K ATPase pump.

Answer 16

Autoimmune gastritis

Question 17

If you lose parietal cells, what vitamin can you now be deficient in?

Answer 17

B12 cuz u lose IF

Question 18

If you lose parietal cells, you lose acid production, but you increase the release of what hormone? Why>

Answer 18

Gastrin cuz it’s reading low acid and keeps getting spit out cuz the body wants to make more acid.

Question 19

Where in the stomach does autoimmune gastritis act?

Answer 19

the body and the fundus

Question 20

What happens to the mucosal lining in the body and fundus when autoimmune gastritis occurs?

Answer 20

it thins and lymphocytes and macrophages are present.

Question 21

Reactive gatropathy is usually caused from what things?

Answer 21

chemical injury, NSAIDs, post-pyloric bypass surgery

Question 22

What do u see with reactive gatropathy in the epithelia?

Answer 22

No neutrophils, mucus hyperplasia, alternating injured/noninjured mucosa (watermelon stomach)

like ur stomach tissues being like “omg wtf was that”

Question 23

Allergic reactions can cause dense accumulations of this type of WBC in this condition.

Answer 23

Eosinophils in eosinophilic gastritis

Question 24

What is the condition when there are increased numbers of intraepithelial lymphocytes (CD8) and varioliform gastritis?

Answer 24

Lymphocytic gastritis

Question 25

Who is at risk for lymphocytic gastritis?

Answer 25

women with celiac disease

Question 26

Chrons and sarcoidosis can cause this condition where aggregates of tissue macrophages can narrow the antrum.

Answer 26

Granulomatous gastritis

Question 27

What are the 2 most common causes of peptic ulcer disease?

Answer 27

H. pylori and NSAID use

Question 28

Where in the GI tract does peptic ulcer disease occur?

Answer 28

duodenum (mainly)

Question 29

What does the defect look like the in the duodenum in peptic ulcer disease?

Answer 29

punched out, usually a big ulcer with dead necrotic tissue, liquefactive necrosis

Question 30

When does the burning sensation occur with peptic ulcer disease?

Answer 30

1-3 hours after a meal, worse at night, and relieved by alkali/food

Question 31

Chronic inflammation can cause 2 mucosal pathological changes. What are they?

Answer 31

mucosal atrophy and metaplasia

Question 32

On histological exam, what do you see in mucosal atrophy and metaplasia?

Answer 32

Goblet cells, big mucus cells (metaplasia), loss of parietal cells (atrophy)

Question 33

Mucosal atrophy and metaplasia are strongly correlated with what type of cancer?

Answer 33

gastric adenocarcinoma

Question 34

Free radical damage from chronic gastritis causes lesions that have genetic alterations, producing this type of cellular change.

Answer 34

Dysplasia

Question 35

In this condition, cysts can stimulate epithelium to proliferate reactively, so you form an epithelium over the gastric epithelia.

Answer 35

Gastritis cystica

Question 36

What usually causes gastritis cystica?

Answer 36

trauma

Question 37

Excessive TGF-a secretion can make a ton of foveolar (mucous) cells, leading to this condition.

Answer 37

Menetrier disease

Question 38

The hyperplasia of the foveolar cells in Mentrier's disease can lead to what type of cancer formation?

Answer 38

Adenocarcinoma

Question 39

This disease is caused by gastrin-secreting tumors from the small intestine or pancreas.

Answer 39

Zollinger-Ellison Syndrome (ZES)

Question 40

In ZES, the excess gastrin causes the proliferation of what gastric cell type?

Answer 40

parietal cells

Question 41

ZES can lead to ulcer formation in what part of the GI tract?

Answer 41

duodenum | overload that bitch with acid

Question 42

This condition is from polyp development with chronic gastritis from reactive hyperplasia.

Answer 42

Inflammatory/hyperplastic polyps

Question 43

Fundic gland polyps can be formed by what type of therapy?

Answer 43

PPI's

Question 44

Fundic gland polyps are associated with what genetic condition?

Answer 44

Familial adenomatous polyposis

Question 45

Gastric adenomas are large (2cm) lesions and can form in what part of the stomach?

Answer 45

antrum

Question 46

What gene is faulty to cause gastric adenocarcinomas?

Answer 46

CDH1 gene, thus losing E-cadherin

Question 47

What do gastric adenocarcinomas look like on physical exam?

Answer 47

Heaped up masses in the antrum, can have signet ring and a "leather bottle" stomach wall appearance.

Question 48

Where is a common lymph node for metastasis of gastric adenocarcinomas?

Answer 48

left virchow's node

Question 49

Why is mucous produced in gastric adenocarcinomas?

Answer 49

because they cause glandular formation, making goblet cells that make mucus

Question 50

Lymphomas are tumors linked with H. Pylori and arise from what type of tissue?

Answer 50

MALT

Question 51

These tumors come from the endocrine system, are mostly in the small intestine, and secrete hormones based off which part of the intestine the tumor is located.

Answer 51

Carcinoid tumor

Question 52

Carcinoid tumors have a yellow/tan polypid lesions and from specific kinds of colonies. What are those islands of cells calls?

Answer 52

islands of uniform cells (endocrine gland markers)

Question 53

c-KIT is a gene that encodes tryosine kinase, and when disrupted, this type of tumor is produced.

Answer 53

Gastrointestinal tumor | lol thats pretty general sounding

Question 54

What can you use to diagnose gastrointestinal tumors?

Answer 54

theyre usually pretty big (30cm) and can use c-KIT to diagnose. tumors are spindle shaped cells

Question 55

Why can gastrointestinal tumors leads to anemia?

Answer 55

from blood loss from the ulcers